Organization Name: | KONALA-NUTHALATATY, PLLC |
NPI Number: | 1013115005 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SAM NUTHALAPATY (OFFICE MANAGER) |
Mailing Address: | 6290 Manchester Hwy Morrison |
State: | TN US |
Postal Code: | 373577589 |
Phone Number: | 9318151616 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2007 |
NPI Last Update Date: | 08/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |